Abstract
The most common metastatic lesions of prostate cancer are in bone and can be classified into three distinct pathology subtypes: lytic, blastic, and an indeterminate mixture of both. We investigated a cohort of decalcified formalin-fixed and paraffin-embedded (FFPE) patient specimens from the bone that contained metastatic prostate cancer with lytic or blastic features. These tissue sections were utilized for immunohistochemistry (IHC) staining, isolation of RNA for gene expression, and Digital Spatial Profiling (DSP) of changes in both the tumor and microenvironment. A diverse set of unique immune cell populations and signaling pathways to both lytic and blastic types of prostate cancer metastases were present. In blastic lesions immune cells were enriched for pSTAT3 and components of the JAK-STAT pathway. In lytic-type lesions, immune cells were enriched for pAKT activity and components of the PI3K-AKT pathway. Enrichment for immune checkpoints including PD-L1, B7-H4, OX40L, and IDO-1 were identified in blastic prostate cancer, providing new therapeutic targets for patients with bone metastases. Biopsies could guide selection of patients into appropriate therapeutic interventions based on protein levels and RNA expression of desired targets in metastatic disease. Molecular pathology has been an excellent complement to the diagnosis, treatment, and management of primary tumors and could be successfully extended to patients with metastatic lesions.
Highlights
Prostate cancers have an improved prognosis in the past two decades, yet metastatic prostate cancer continues to cause high mortality with more than 30,000 deaths in the U
Prostate cancer has a unique predilection for metastasis to bone, which most commonly presents as blastic or sclerotic bone lesions, resulting in abnormal growth and stimulation of
We investigated a collection of decalcified formalin-fixed and paraffin-embedded (FFPE) human archived bone tissue samples containing prostate cancer with features of lytic or blastic disease
Summary
Prostate cancers have an improved prognosis in the past two decades, yet metastatic prostate cancer continues to cause high mortality with more than 30,000 deaths in the U. S estimated for 2019 [1]. Most prostate metastases occur in the bone. Treatment for metastatic prostate cancer involves systemic chemotherapy standard of care combined with new and established immunotherapies [2]. Prostate cancer has a unique predilection for metastasis to bone, which most commonly presents as blastic or sclerotic bone lesions, resulting in abnormal growth and stimulation of. Ihle et al Journal for ImmunoTherapy of Cancer (2019) 7:293
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